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K04.6

Billable

Periapical abscess with sinus

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A pus-filled pocket of infection at the root tip of a tooth that has drained to the surface through a sinus tract or opening.

Coding Tips

  • •The presence of a sinus tract is the key distinguishing feature; document the location of the sinus opening
  • •Confirm the abscess is periapical (at the root tip) rather than periodontal in origin

Code Hierarchy

└K04Diseases of pulp and periapical tissues└K04.6Periapical abscess with sinus
└K04.6Periapical abscess with sinus

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